The Hospital District Selects a New Commissioner

At the May 2 meeting, the Hospital District interviewed two candidates to replace Robin Nault. Stephen Falk was one. I (Vic Riley) was the other.

The Interview

The two remaining commissioners, Kandy Harper and Dick Williams, asked each of us five substantive questions. This is a transcript of the questions and our answers.

1. What appeals to you about being a commissioner for the Point Roberts Public Hospital District?

Falk	Riley
Well I think as a supporter of the district and the clinic it supports, I’d be pleased to be involved in overseeing the operations and the interactions with the other health care agencies that are involved. I think my commitment to the community has gotten me to this point after my involvement with the Park District and the library project that’s been going on now for the last many years and is about to culminate in a new library. But specifically with respect to the Hospital District, I think it’s really mostly my sense of commitment to the community and to having a strong clinic and Hospital District supporting it.	Well, as you may know, I was one of the founding commissioners. I served for a couple of years while we got the district up and running. My wife Shannon was one of the people who established the taxing district, and we did that because we wanted to have a clinic here, we wanted to have access to health care here on the Point, and because the clinic existed and was only being supported by a grant, we felt that a taxing district was the only way to make it viable long term. I want to keep it that way. I want the clinic to stay open. After attending your meetings for the last year, I think I have a pretty good understanding of what some of the challenges are, and I have some ideas for how to mitigate those challenges, so I’d just like the opportunity to do it. And actually, I think Robin took my place when I left in 2007 so I’m asking for the opportunity to take her seat back again.

Falk

Riley

Well I think as a supporter of the district and the clinic it supports, I’d be pleased to be involved in overseeing the operations and the interactions with the other health care agencies that are involved. I think my commitment to the community has gotten me to this point after my involvement with the Park District and the library project that’s been going on now for the last many years and is about to culminate in a new library. But specifically with respect to the Hospital District, I think it’s really mostly my sense of commitment to the community and to having a strong clinic and Hospital District supporting it.

Well, as you may know, I was one of the founding commissioners. I served for a couple of years while we got the district up and running. My wife Shannon was one of the people who established the taxing district, and we did that because we wanted to have a clinic here, we wanted to have access to health care here on the Point, and because the clinic existed and was only being supported by a grant, we felt that a taxing district was the only way to make it viable long term. I want to keep it that way. I want the clinic to stay open. After attending your meetings for the last year, I think I have a pretty good understanding of what some of the challenges are, and I have some ideas for how to mitigate those challenges, so I’d just like the opportunity to do it. And actually, I think Robin took my place when I left in 2007 so I’m asking for the opportunity to take her seat back again.

2. In what area could you contribute the most based on your previous experiences?

Falk	Riley
Well, as a long time attorney, I might be able to bring some useful skills to bear in support of Hospital District activities, either in terms of organizational activities or review of agreements and documents. From my experience on the Park District I think I can bring to bear just a general organizational sense of a public district, how it operates, what it needs to accomplish, how it works with others in its orbit.	Well, my Bachelor’s degree is in Architecture, I’ve got a Ph.D. in Experimental Psychology, I know statistics and management. I’ve worked in Human Factors research and engineering for thirty four years, most of that time running fairly large R&D projects with large budgets, doing the cost tracking, managing the team. I’ve also won a lot of government contracts in my work. In fact, for about five years, I ran my own consulting company. We had contracts with the FAA, with NASA, several other government agencies, and I think that my experience writing proposals for those funds might potentially come in handy. I think one of the things that we could do as a district is apply for federal grants to provide more support for the clinic. I’ve got a lot of experience in that area that I think could come in handy and I’d like to contribute that if I can.

Falk

Riley

Well, as a long time attorney, I might be able to bring some useful skills to bear in support of Hospital District activities, either in terms of organizational activities or review of agreements and documents. From my experience on the Park District I think I can bring to bear just a general organizational sense of a public district, how it operates, what it needs to accomplish, how it works with others in its orbit.

Well, my Bachelor’s degree is in Architecture, I’ve got a Ph.D. in Experimental Psychology, I know statistics and management. I’ve worked in Human Factors research and engineering for thirty four years, most of that time running fairly large R&D projects with large budgets, doing the cost tracking, managing the team. I’ve also won a lot of government contracts in my work. In fact, for about five years, I ran my own consulting company. We had contracts with the FAA, with NASA, several other government agencies, and I think that my experience writing proposals for those funds might potentially come in handy. I think one of the things that we could do as a district is apply for federal grants to provide more support for the clinic. I’ve got a lot of experience in that area that I think could come in handy and I’d like to contribute that if I can.

3. What do you think the two biggest learning curves will be?

Falk	Riley
For me? Well, I know the clinic exists but I have not been involved in any aspect of any operations of the Hospital District or the clinic or its interactions with Unity Care, so I would be learning what actually goes on will be the biggest issue for sure. I’ve always been a fast learner, I think I still am, so I’ll get on board fairly quickly once I’m involved, if I’m involved.	After attending the meetings for the last year or so, and looking at a lot of background information on the district and on the clinic, I think I’ve got a pretty handle on what the issues are and what I would do about them.

4. What do you think are the biggest obstacles facing the Hospital District?

Falk	Riley
Well, in a sense, I think interacting with the community, having a greater sense of involvement of the community with the Hospital District and the clinic, have it provide greater service to more of the community if that’s possible without breaking the boundary. I know there are some issues with members of the public who have some concerns about the district, it would be nice to come to terms with if that can be done, but I don’t know if that’s feasible.	I think the biggest challenge that I’ve seen is the number of patients. I know that as patients go down, that patient-related revenues also go down and the need for taxing subsidies goes up. And I know that the clinic has been operating kind of on the edge for the last few years, and that the difference between a profit and a loss has been based on the mix of patients: Medicaid vs. Medicare, insured vs. uninsured. I’d like to establish a more solid financial basis for running the clinic. I’m sure some of you may think I’m opposed to Unity Care; I’m definitely not, I want to work with them and I hope they’ll work with me. And I would like to be more active in trying to increase the number of patients who come to the clinic. I think there are opportunities to be more collaborative, for example with the Fire District and their health care initiatives. We could work with the CARES program to bring more people into the system and potentially bring more people into the clinic. I would like to see the Hospital District be forward-looking and optimistic and collaborative, working with all the other groups, both formal and informal, Fire District, Circle of Care, whatever, to bring services to as many people as possible, and I hope that that will also bring more people into the clinic and provide more patient revenues for Unity Care. If, because of demographics or some other reason, the patient numbers don’t go up, I would be willing to propose going to the taxpayers and asking them to vote on a levy to see if they would be willing to increase more subsidies to the clinic to make up that shortfall.

Falk

Riley

Well, in a sense, I think interacting with the community, having a greater sense of involvement of the community with the Hospital District and the clinic, have it provide greater service to more of the community if that’s possible without breaking the boundary. I know there are some issues with members of the public who have some concerns about the district, it would be nice to come to terms with if that can be done, but I don’t know if that’s feasible.

I think the biggest challenge that I’ve seen is the number of patients. I know that as patients go down, that patient-related revenues also go down and the need for taxing subsidies goes up. And I know that the clinic has been operating kind of on the edge for the last few years, and that the difference between a profit and a loss has been based on the mix of patients: Medicaid vs. Medicare, insured vs. uninsured. I’d like to establish a more solid financial basis for running the clinic. I’m sure some of you may think I’m opposed to Unity Care; I’m definitely not, I want to work with them and I hope they’ll work with me. And I would like to be more active in trying to increase the number of patients who come to the clinic. I think there are opportunities to be more collaborative, for example with the Fire District and their health care initiatives. We could work with the CARES program to bring more people into the system and potentially bring more people into the clinic. I would like to see the Hospital District be forward-looking and optimistic and collaborative, working with all the other groups, both formal and informal, Fire District, Circle of Care, whatever, to bring services to as many people as possible, and I hope that that will also bring more people into the clinic and provide more patient revenues for Unity Care. If, because of demographics or some other reason, the patient numbers don’t go up, I would be willing to propose going to the taxpayers and asking them to vote on a levy to see if they would be willing to increase more subsidies to the clinic to make up that shortfall.

5. What would you like to accomplish as a Hospital District commissioner?

Falk	Riley
Well, I think I’d like to see smooth operations of the commission, in its internal operations and its operational management of its responsibilities.	(Commissioner Harper, in asking this question of me, noted that I had already answered this question and asked if I had anything more to add. I did not.)

Comment

I offered the Hospital District an opportunity to collaborate with the Fire District to bring improved services to the Point and increase clinic utilization. It's worth noting that my wife Shannon Tomsen is no longer on the Fire Commission, and that a Fire Commissioner is married to a Hospital District Commissioner, yet relations between the two districts have not improved. I think this is because the Hospital District continues to view the Fire District initiatives such as the CARES program as threats rather than as opportunities, as demonstrated by Elaine Komusi in her resignation speech.

The Executive Session

Commissioners are legally required to conduct all business in open meetings with a few exceptions, such as discussing personnel performance and, in this case, the merits of candidates for the commission. Typically, due to the sensitivity of these discussions, commissioners meet alone. In this case, however, Elaine Komusi ran the process and sent everyone out of the room except for those who would be present for the commissioners' supposedly private deliberations.

Those who remained in the room for these deliberations included:

Outgoing Superintendent Elaine Komusi
Incoming Superintendent Barbara Wayland
Financial Advisor
Recording Secretary who was also a Unity Care employee

Yes, a Unity Care employee was present for the private deliberations of two commissioners to select a new commissioner for the taxing district that procures services from her employer.

Stephen Falk and I chatted while we waited, and I suggested that we meet to discuss our concerns, whichever of us won. To his credit, he agreed.

The Decision

Stephen Falk was selected.

The Mistake

At the time of their decision, the commissioners had been told by District Secretary that the position they were filling was up for election in six months. The following day, she informed them that she had made a mistake and the position actually expires at the end of 2019.

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